OPHTHALMIC SURGEON
Specialist in Glaucoma, Cataract, Pediatrics

Strabismus in children.

Easily identifiable, strabismus is characterized by one eye being deviated, not looking in the same direction as the other. It can occur from birth or years later, and ophthalmological check-ups are required to treat this deviation of the eye in children.

Strabismus in children
A young girl with strabismus tries on a new pair of wire-rimmed glasses.

What is strabismus?  

Strabismus is a pathology of the eye: it is a defect of alignment and coordination of the eyes. The axes of vision are not aligned, and we can notice that each eye fixes a different direction.

Strabismus can be found from birth but can also appear later, in adolescence or adulthood. There is no age to develop strabismus. It affects between 1 and 2% of the French population, all ages included. It is a pathology of the eye that is estimated to be rather frequent and requires a consultation with the ophthalmologist.

There are three types:

  • Vertical strabismus, when one eye moves up or down.
  • Divergent strabismus, when one eye is deviated towards the exterior (towards the temple).
  • Convergent strabismus, when one eye deviates inwards (towards the nose).

The other eye keeps its axis towards the observed object.

It is important to know that : appearing late in life can lead to diplopia, i.e. double vision. This pathology can be treated with glasses, as well as an operation from the age of 4 to 5 years old if necessary.

When must we consult for a children?

It is important for parents to pay special attention to strabismus in children. If you notice that an eye seems to be crossing or deviating, with an increase in the axis during the day, but also difficulties in orienting themselves in a given space, quickly make an appointment with an ophthalmologist.

There is no minimum age for a consultation.

Generally speaking, it should be detected in children between 6 and 9 months after birth. This screening allows the detection of early congenital strabismus. Regular screening follows: this eye pathology is best treated by specialists before the age of 6.

After 6 years of age, you will be advised to make an appointment every 1 to 2 years according to the ophthalmologist’s recommendations.

During the appointment, an ophthalmological examination will be performed with eye fundus observation and cycloplegia examination. These examinations are suitable for infants and children of all ages. Screening in early childhood can prevent many of the consequences, such as amblyopia, which causes a defect in the development of the eye’s vision. The fixed eye, unaffected by strabismus, does all the work, while the other eye, unused, gradually loses its ability to see.

What is the cause in children

There are many possible causes in children, of whom 5% are affected by this pathology.

Uncorrected hyperopia (long sightedness) can be the cause in children.

For children under six months of age, a potential explanation is premature birth, family medical history, genetic diseases such as Down syndrome, congenital eye defects, cerebral palsy, or prenatal exposure to drugs (alcohol, tobacco, etc).

For children over six months of age, the cause can be significant hyperopia, neurological conditions, head trauma, nerve weakness, and other conditions that can cause temporary or constant misalignment of the child’s eye.

It can be congenital, appearing from birth or during the first months. Around 2-3 years of age, if the strabismus is corrected by wearing glasses, it will be called accommodative, partial or total strabismus.

In order to set-up an ophthalmological check-up and prevent strabismus in your child, we strongly invite you to make an appointment with an ophthalmologist following the recommended age guidelines in this article.

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